Expert consensus survey updates terminology on globe, adnexal trauma
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A group of international ocular trauma experts reached consensus that the Birmingham Eye Trauma Terminology system, or BETTs, is still appropriate for clinical use.
They also agreed on the need for new terminology to further classify globe and adnexal injuries.
A two-round modified Delphi survey was conducted among 69 experts with significant experience in trauma surgery, identified through their membership in globe and adnexal trauma societies. After identifying key topics and gaps in the current terminology, a steering committee within the International Globe and Adnexal Trauma Epidemiology Study Ophthalmic Trauma Terminology Consensus Group developed questions and analyzed the responses. Consensus was considered to be reached when at least 67% of respondents indicated agreement.
Consensus was achieved for 82% of the current definitions (nine of 11) provided by the BETTs, supporting continued use in clinical practice. New terms identified to address gaps in the existing terminology, particularly regarding globe and adnexal injuries, reached consensus in 65% of the questions (11 of 17) in round 1 and in 57% of the questions (four of seven) after redefinition in round 2. The new terms included the mechanism of injury, classified as sharp, blunt, mixed, intraocular foreign body, bite and burn, in the definition of globe and adnexal trauma, a more precise description of location of injuries, and the inclusion of lens status information and retinal involvement. Consensus was also achieved on the introduction of the new term “globe and adnexal trauma” to replace the previous term “ocular trauma” for an injury to the globe and adnexa.
“We hope our findings will improve communication between clinicians managing ocular trauma as well as research in the area,” the authors wrote. Extended, more detailed definitions should also support “a more complete evaluation and prognostic assessment.”
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